Pivoting injury prevention efforts during a pandemic: results of an international survey

Background The COVID-19 a pandemic changed the world. Public health directives to socially distance with stay-at-home orders altered injury risk factor exposure, resulting injury patterns and conducting injury prevention (IP). The objective of this study was to determine the impact the COVID-19 pandemic on injury and IP at North American trauma centers (TC). Results Sixty-two responses were received from pediatric (44%), adult (11%), and combined (31%) TC, from 22 American states, 5 Canadian provinces and Australia. The majority (91%) of programs targeted age groups from birth to 15 years old. Nearly one-third reported IP to be less of an institutional priority with funding redistributed in 15% of centers [median (IQR) − 25% (− 43, 1)], and resultant staffing changes at 38% of centers. A decrease in IP efforts was reported at 64% of TC. Overall, the majority of respondents reviewed injury data, with the top reported increased mechanisms mainly intentional: Firearm-related (75%), assaults (72%), and abuse (71%). Leading increased unintentional injuries were injuries occurring in the home such as falls (70%), followed by ATV (62%), and cycling (57%). Sites pivoted by presenting (74%) or participating (73%) in IP education virtually, social media posts (61%) and the addition of technology (29%). Top barriers were redeployment of partners (45%) and staff (31%), as well as lack of technology (40%) in the target population. Facilitators were technology at TC (74%), support of trauma program (63%), and having IP funding maintained (55%). Conclusions Nearly two-thirds of TC decreased IP efforts during the pandemic due to staffing and funding reductions. The leading reported increased injuries were intentional, indicating that violence prevention is needed, along with support for mental health. While TC successfully pivoted by using technology, access issues in the target population was a barrier resulting in health inequities. Supplementary Information The online version contains supplementary material available at 10.1186/s40621-023-00472-3.


I. Injury Prevention Initiatives
What are the age groups your injury prevention efforts Infants (< 1 year) target?
Early Adolescence (10-15 years) Late Adolescence (16-17 years) Young Adults (18-24 years) Adults ( 25  Please enter up to 5 staffing changes (decreases or increases) since the pandemic, along with the full-time equivalent (FTE) (i.e., 1 for full-time staff, 0.2 for each day worked for part-time staff).
For redeployment, temporary lay-off/furlough or leave of absence (LOA), please enter the length of time.
If a position was funded by separate sources, please enter on separate rows, specifying the FTE by each funding source.In-person institution will take in the future?

VI. Facilitators & Barriers to Pivoting During the Pandemic
Please specify the facilitators allowed you to successfully pivot your injury prevention efforts during the COVID-19 pandemic (Check all that apply) Since the start of the COVID-19 pandemic, has injury Yes data been reviewed to keep the Injury Prevention team No informed of current injury epidemiology?Please check all data sources that have been reviewed: Emergency Department data Hospital In-Patient Data Trauma Registry Data Coroner's/Death Data Injury-specific databases (i.e., MVC data, abuse registries, etc.) Other injury data, please specify: ______ (Check all sources reviewed by someone on IP &/or Trauma Program Team) For each of the following injury mechanisms, please specify any trends in the number of cases seen at your institution since the start of the COVID-19 pandemic.If you haven't reviewed or been informed of changes in volumes to one of these mechanism of injury, please specify "Don't know".
Please identify the level and direction of change in the following types of injury prevention efforts at your institution, since the start of the COVID-19 pandemic.If your institution doesn't have a specific type of program or partnership, restrictions are lifted and we move Virtual forward from the COVID-19 pandemic, what format do you Hybrid of virtual & in-person feel most injury prevention programs at your

Please select the response that best describes the level of importance of Injury Prevention as an institutional priority, since the declaration of the COVID-19 pandemic.
Please enter the % of injury prevention funding, by source, prior to the pandemic.If yes, please enter the changes to the injury prevention funding, by source, since the start of the pandemic, along with the impact of any decreases, or increases, in funding.

Changes in Injury Prevention Efforts Due to the Pandemic Please
specify any innovations with your injury prevention efforts since the start of the COVID-19 Pandemic.Check all that apply & provide further details or links, if you are able.(Check all that apply) Presenting Injury Prevention Education virtually via Zoom/WebEx/other platform Participating in Injury Prevention Education virtually via Zoom/WebEx/other platform Posting Injury Prevention Messages on Social Media, platforms: ______ Development of public health social media/social marketing campaigns, please specify or provide link: